High Anxiety

This piece originally appeared in The Sunday Times Style on 6th December.

When I was five years old, I told my mother that my teacher didn’t like me. “What can I do to make her like me?” I asked.

For as long as I can remember, I have lived within this framework of angst. It ebbs and flows along the contours of my life. Sometimes I can make sense of it, but often it pulsates arbitrarily, even at times when things are going well. For instance, I felt anxious writing this piece. Anxious that my editor wouldn’t like it, anxious that I might write about anxiety in the wrong way, anxious that I wouldn’t meet my deadline.

My anxiety is largely a social anxiety: a fear of being judged, misunderstood or disliked. I cannot walk out of a room without feeling crippled by paranoia that everyone will start talking about me. If I send a text and a friend fails to reply, it can send me into a private spiral that lasts days, where I convince myself that I have done something wrong. Not a day goes by when I do not seek reassurance in some capacity. If I don’t have anything to feel anxious about, I will create something. Anxiety feeds anxiety. To recall a full day when I have not felt tense in my shoulders, twisted in my stomach, balled my fingers into fists, or ground my teeth, is impossible.

I am one of many twentysomething women waging their own war against this insidious mental beast. “In my 20 years of clinical practice, I’ve noticed a new attendance in women aged 20 to 29 coming to me for issues relating to anxiety,” says the wellbeing expert Vivienne Talsmat (viviennetalsmat.com). Celebrities around my age, such as Lena Dunham, Amanda Seyfried and Zoella, are confessing to feelings of anxiety in their droves.

Within minutes of casting around, I find dozens of anxious twentysomething women suffering from generalised anxiety disorder (GAD), social anxiety, paranoia, panic attacks and obsessive compulsive disorder (OCD). “I had my first panic attack six years ago. My first response, whenever anything goes wrong, is to assume that it is my fault. I can actually convince myself that I have done things,” says Felicity, 28, an art director. “It’s a cliché, but I think it stems from my Catholic upbringing. My family are totally boggled by it and don’t understand my rationale, or lack of it, at all.”

Rosa, 27, a trainee psychologist, worries that her anxiety will affect her ability to do her job. “My job is to help people acknowledge their own compulsive thought patterns and to drop their perfectionist standards, but I am terrible at doing those things myself. It’s so ironic. I’m terrified that if people find out that I suffer from those feelings, they will think it affects my ability to do my job — if I can’t solve my own problems, how will I solve theirs?”

Five years ago, Belinda, 29, a teacher, found the “white-wine dreads” escalating into full-blown paranoia. She’d drink to forget her anxiety, then hate who she became, which led her to drink more. Eventually, she sought treatment and became teetotal.

Where has this cultural epidemic come from? A spot- and angst-ridden teenagehood was to be expected, but I foresaw my twenties as a time to be footloose and fancy-free, a decade of minibreaks and Topshop sprees. I’ve seen Bridget Jones. I’m meant to be dyeing my soup blue and running into the street in my knickers. I have a job, a roof over my head and I’m getting married next year. What the hell have I — we — got to worry about?

Suky Macpherson, a chartered psychologist who specialises in young people, summarises modern anxiety in one word: pressure. Its forms are multifactorial, ranging from the price of property, the hopes of our parents and the rise in graduates (and thus more people chasing the same jobs), to university debt, fertility issues and an attachment to technology — and how that affects us, in terms of the pressure to succeed. But surely our times cannot be more stressful than those our predecessors lived through?

“Biologically, our bodies respond to anxiety in the same way, whether you are running from a sword or late on a deadline. We are configured to fight or flee. But we don’t have the physical outlet of battle any more. So we are getting the physical symptoms of stress — beating heart and shaking — but it’s all trapped inside our head,” Macpherson says. A lot of the anxiety in women she sees comes from searching for the right partner, which sounds depressingly archaic. She doesn’t disagree. “The pressure to find a mate has always been there, but people were doing it without pathologising it.”

There is both a luxury and a detriment to the knowledge and choice we now possess as young women. Unlike my predecessors, I have been raised to think that I can be anything I want to be. I tell Macpherson that, in my anxious mind, this translates as being everything: a career woman, a homemaker, a good friend. I’ve been known to go to Sainsbury’s at 7am in order to race home, marinate meat and lay the table before work — ahead of that evening’s dinner party. “Whether women can ‘have it all’ is a debate that still rages,” Macpherson says. “This is still a patriarchal society. There is still a glass ceiling. As Jerry Hall once said, a woman has to be ‘a maid in the living room, a cook in the kitchen and a whore in the bedroom’.” Now women may feel they have to be all that and more — before they even have children (all but one of the women I spoke to were childless).

Unsurprisingly, social media is a problem. “Comparisons on social media pertaining to the perfect lifestyle provide unrealistic ideals of how life should be,” Talsmat says . I don’t think social media makes me anxious, I argue. I’m not a teenager, I like to think I’m in control of it.

Macpherson says it is this very desire to be in control that’s the problem. “Twentysomething women were brought up with the illusion that they can control their lives,” she says. “So they feel a need to control the uncontrollable.” She’s right. One of the things I like the least about myself is a desire to control things.

Don’t shoot the messenger, but all the experts I speak to cite modern culture’s predilection for hype. And the impulse to self-diagnose and a tendency to casually misuse terms such as “anxiety” and “depression” means that, Macpherson argues, health anxiety and hypochondria feed into each other.

Anxiety is not a new emotion, it is a natural, genetic human condition, says Dr Michael Sinclair, the clinical director at City Psychology Group. “What has changed is the way we relate to it. Ours is a quick-fix culture, which means we do not accept anxiety and learn to tolerate those feelings,” he adds.

Sinclair and Macpherson say young people now have a lower tolerance for discomfort and panic at the first sign of distress. We cannot accept a bad week, month or year in the same way perhaps our parents did. That doesn’t mean anxiety is trivial, though. Through 24/7 news coverage, it can feel as though the world is not as safe as it used to be, says Macpherson. Everything from terrorism to an evolving society to a breakup (a common trigger) can feed into anxiety.

Luckily, my anxiety has never been chronic. I know people who cannot leave the house without a cocktail of pills. One friend is weaning herself off Benzos (on the advice of her doctor) after three years. She says she feels “constantly dizzy”. I am aware how lucky I am that that has never been my reality. I sought treatment five years ago, when I tried cognitive behavioural therapy (CBT), which proved unsuccessful, so I am left wondering if it’s my fault for not addressing it earlier.

So, is there anything to be optimistic about? Well, while anxiety in twentysomething women is undeniably worsening, it means there is an increased demand for a solution. Nutritional psychiatry is a step forward in managing anxiety. Talsmat recommends Rejuva|Detox, which apparently supports the liver and adrenal glands and “adds a cascade of B vitamins and the essential minerals and antioxidants to combat stressful city living”. There are studies under way into cortisol, the “stress hormone” that causes unpleasant reactions, and the benefits of magnesium. The American naturopath Dr Carolyn Dean wrote The Magnesium Miracle, a controversial book that suggests that having enough magnesium in your diet can decrease anxiety.

For chronic anxiety, Sinclair recommends acceptance and commitment treatment (ACT), a modern form of CBT and, he says, a “brilliant, mindful form of treatment”.

Mindfulness crops up with most of the experts I speak to. I downloaded the Headspace app (yes, I know, I’m late to the party). Talsmat also recommends meditation and exercise as proven ways to combat anxiety. “Exercising three or four times a week keeps my anxiety at bay,” says Lena, 29, a fashion stylist who suffered from debilitating anxiety after being bullied at work. Similarly, a healthy diet helps.

I know all of this — and yet. Here I am, skipping lunch in favour of a doughnut, checking my emails at midnight and skipping my gym class. Writing this makes me realise that I don’t have any excuses left.